The intent of this application is to document the ability of The Cleveland Clinic Foundation to participate as an effective and productive clinical center in the proposed multicenter clinical trial, entitled "Collaborative Initial Glaucoma Treatment Study" (CIGTS). This study's purpose is to evaluate whether initial treatment of open angle glaucoma is more effective by means of a stepped medical regimen or by means of a surgical approach. The Cleveland Clinic Foundation's clinical center will participate in the CIGTS by identifying and recruiting eligible patients, administering the treatment regimen as assigned by the CIGTS's Coordinating Center and defined within the study's Manual of Operations, following and retaining study patients, recording and transferring study data to the Coordinating Center, and contributing to reports that will present CIGTS results. This application describes the ability of The Cleveland Clinic Foundation's Clinical Center to enroll approximately 45 patients per year, based upon pilot studies of patient eligibility conducted during a three month period. Details are provided of the plans to identify, recruit, follow, and retain these patients, our intent to obtain consistently high quality data on the visual outcomes of treatment, and the personnel, and facilities available within our center to carry our the provisions of the CIGTS's Manual of Operations.